Seamus O’Mahony

Dr Trotter challenged Freud, asserting that ‘all human psychology … must be the psychology of associated man, since man as a solitary animal is unknown to us’

Neuroscientific speculation has escaped from the laboratory and is now the rickety foundation for scores of bestselling, populist books. The sceptical writer and journalist Steven Poole has described the phenomenon as ‘an intellectual pestilence’ and ‘neurotrash’.

Up to 1 per cent of the population may have coeliac disease but many more have self-diagnosed themselves as gluten-sensitive. Is gluten sensitivity based on any scientific evidence or is it the product of a misalliance between academic medicine and commerce?

Many patients with a debilitating terminal disease might, one would think, be glad to hear their time is short. Still, ignoring the statistics, oncologists will offer ‘hope’ and more treatment. Why, asks the old doctors’ joke, do coffins have nails? To keep the oncologists out.

Jerry Coyne’s shouty polemic against religion, and against the possibility of any accommodation between science and religious belief, is largely an attack on creationism and ‘ìntelligent design’. It is hard to see it being taken seriously anywhere but in the US.

In a series of radical critiques published in the 1970s Ivan Illich questioned educational practice, managerialism and the medical profession. Though he could be arrogant, inconsistent and even plain silly, Illich had important things to say about modernity.

The ghosted autobiography of Roy Keane and a biography of England’s 1966 World Cup golden boy Bobby Moore illustrate hugely contrasting personalities, but also the enormous changes that have come over the culture of the beautiful game during the last fifty years.

‘The Hard Conversation’ is what happens when a doctor reveals to a patient the no longer avoidable truth. But perhaps society should also have a hard conversation about the limits of medical science and the desirability of providing not infinite life but a decent end of life.

Sigmund Freud did not care greatly for his patients, and learning and teaching were more to his taste than helping and healing. Nevertheless, psychoanalysis has become in our age the pervasive orthodoxy of self-knowledge, even if its scientific claims are on a par with those of, say, aromatherapy.

Surgery, and perhaps particularly neurosurgery, can be profoundly rewarding. But there is always the possibility of mistakes, those little slips that can lead to disaster and another headstone in the cemetery that all surgeons carry around with them.